2009 H1N1 Influenza in Children

What is 2009 H1N1 influenza?

The 2009 H1N1 influenza virus (or flu) is a contagious viral respiratory tract infection. 2009 H1N1 flu is characterized by the abrupt onset of symptoms similar to seasonal flu, such as fever, muscle aches, and sore throat.

This virus was originally referred to as swine flu because many of its genes resemble a virus that normally occurs in pigs. Additional research has shown, however, that 2009 H1N1 flu is made up of swine flu genes as well as avian and human flu genes.

The World Health Organization (WHO) declared 2009 H1N1 flu a global pandemic in June 2009. As of September 20, 2009, the WHO estimated that 2009 H1N1 is widespread in the U.S., Canada, Mexico, parts of South America, Ireland, New Zealand, Thailand, Australia, and Cambodia. The virus also has spread regionally throughout Brazil, India, and Indonesia, and locally throughout Europe.

Although the virus has spread globally, most individuals in the U.S. who have contracted the virus have fully recovered without medical treatment.

Facts about 2009 H1N1 influenza:

Unlike seasonal influenza, 2009 H1N1 infections have occurred mainly in younger people. 2009 H1N1 flu is similar to seasonal flu in that it can range from mild to severe, and can be deadly in some cases. Children with chronic medical conditions are at higher risk for complications and death from 2009 H1N1 due to their poor ability to tolerate infection. Researchers believe that some children at high risk for seasonal flu complications are also at higher risk for complications from 2009 H1N1 flu.

What causes 2009 H1N1 influenza?

As with seasonal flu, 2009 H1N1 flu is generally passed from person to person by airborne transmission (for example, sneezing or coughing). But, the virus can also live for a short time on objects--such as doorknobs, pens, pencils, keyboards, telephone receivers, and eating or drinking utensils. Therefore, it may also be spread by touching something that has been handled by someone infected with the virus and then touching your own mouth, nose, or eyes.

People who have 2009 H1N1 flu are considered contagious starting one day before they show symptoms and for up to seven or more days after the illness starts. Children and individuals with weakened immune systems may be contagious for an even longer period of time. 2009 H1N1 flu is not spread through food. Eating well-cooked pork and pork products does not pose any risk for infection from this virus.

What are the symptoms of 2009 H1N1 influenza?

2009 H1N1 flu symptoms are similar to the most common symptoms of the flu. However, each child may experience symptoms differently. Influenza is called a respiratory disease, but the child's whole body seems to suffer when he or she is infected. Children who contract 2009 H1N1 flu usually become acutely ill with several, or all, of the following symptoms:

Fever

Headache

Runny or stuffy nose

Cough

Aches and pains

Fatigue

Sore throat

Chills

Some children may also experience diarrhea and vomiting. It is important to note that children do not always display these symptoms, and may experience difficulty breathing and be less active than normal.

If your child experiences one or more of the following symptoms, seek emergency medical care immediately:

Fast breathing or trouble breathing

Bluish or gray skin color

Not drinking enough fluids

Not waking up or interacting

Being irritable and not wanting to be held

Persistent or severe vomiting

Flu symptoms that improve and later return with fever and worse cough

Treatment for 2009 H1N1 influenza:

Specific treatment for influenza can vary, and will be determined by your child's physician based on:

Your child's age, overall health, and medical history

Extent of the virus

Severity of symptoms

Tolerance for specific medications

Expectations for the course of the disease

Your opinion or preference

The goal of treatment for 2009 H1N1 influenza is to help prevent or decrease the severity of symptoms.

Treatment in children includes ample rest and intake of fluids, such as water, juice, and Pedialyte. Children who become ill and display typical flu-like symptoms should remain at home. Depending on your child's age, his or her doctor may also recommend over-the-counter medicines to ease the discomfort of fever, sore throat, and muscle aches. Aspirin should never be used to alleviate these symptoms.

If your child has come in contact with someone who has 2009 H1N1 flu, see his or her doctor and ask if any antiviral medicines can be used to prevent illness.

How to prevent 2009 H1N1 influenza:

There are everyday precautions you and your children can take to protect them from getting 2009 H1N1 flu. Following these measures may be helpful:

Show children how to properly wash their hands with warm soap and water for at least 20 seconds.

Teach children to avoid touching their eyes, nose, or mouth.

Keep surfaces clean by wiping them down with a household disinfectant.

Tell children to maintain a safe distance from people who are sick.

Teach children to cough or sneeze into a tissue, their elbow, or their upper arm.

Teach children not to share cups, utensils, or bottles.

If your children become sick, keep them at home until their fever has been gone for at least 24 hours.

Some people may choose to have their children wear a face mask in crowded settings, though the mask's ability to control the spread of 2009 H1N1 flu is not known at this time.

What types of 2009 H1N1 influenza vaccines are available?

Two forms of vaccine are available to prevent 2009 H1N1 influenza: a nasal spray, known as live, attenuated intranasal vaccine (LAIV), and a shot known as an inactivated vaccine or "flu shot." The 2009 H1N1 LAIV contains live, weakened viruses, while the 2009 H1N1 flu shot contains killed viruses. Both forms of the vaccine are produced by the manufacturers who make seasonal flu vaccines, and they are made in the same way as seasonal flu vaccines.

When and where are 2009 H1N1 influenza vaccines available?

The U.S. Food and Drug Administration has approved several 2009 H1N1 vaccines, and they are currently offered in some states for certain people. Ask your doctor if the 2009 H1N1 flu vaccines are available in your area. If they are, your doctor can tell you if your child should receive the vaccine based on his or her age and existing health conditions.

Children who are age 9 and under should receive two doses of a vaccine, about a month between each dose. All other individuals approved for vaccination should only receive one dose.

Vaccines are beginning to be available in pharmacies, workplaces, and vaccination clinics set up by local schools, health departments, and health care provider offices. Every state has its own plan of action for administering vaccines.

What are the side effects of the 2009 H1N1 flu vaccines?

The CDC expects any side effects to be rare, but similar to those seen after receiving a typical flu shot. Side effects of the 2009 H1N1 flu shot may include:

Fever

Headache

Muscle aches

Redness, soreness, or swelling at the injection site

Nausea

Fainting (though this mainly occurs in adolescents)

These symptoms will usually occur soon after your child receives the shot, and should last for only a couple days.

Side effects of the 2009 H1N1 LAIV should be similar to side effects seen with seasonal flu LAIV. These include:

Fever

Headache

Muscle aches

Abdominal pain

Occasional vomiting or diarrhea

Nasal congestion and/or runny nose

Cough

Wheezing

If your child has a severe, life-threatening allergic reaction to the flu shot or nasal spray, seek medical attention immediately. Symptoms will appear very soon after the vaccine has been administered and may include:

Paleness

Dizziness

Fast heart beat

Hives

Weakness

Difficulty breathing

Hoarseness or wheezing

Swelling around the eyes or lips

Who should immunize against 2009 H1N1 influenza?

The CDC recommends that these child-related groups receive the 2009 H1N1 flu shot in addition to the regular flu shot:

Pregnant women

Health care workers

People 6 months to 24 years old

Caretakers of and people who live with children younger than 6 months

Because infants have a higher risk for flu complications and the vaccine is not approved for those younger than 6 months, experts believe vaccinating people who have close contact with them can help protect infants from getting 2009 H1N1 flu.

2009 H1N1 LAIV can only be administered to certain children depending upon their age and existing health conditions.

According to the CDC, certain children should not receive the 2009 H1N1 LAIV:

Children with long-term health problems

Children with weakened immune systems

Children in close contact with someone who has a severely compromised immune system

Children younger than age 2

Children and adolescents on long-term aspirin treatment

Children with nerve and muscle disorders that may lead to breathing and swallowing problems

If your child has any of the following health conditions, consult his or her doctor before your child receives either vaccine:

Your child is moderately to severely ill

Your child has a severe allergy to eggs or any other substance contained in the vaccine

Your child has Guillain-Barre syndrome

Your child had a life-threatening reaction after receiving a seasonal flu vaccine

Traveling and exposure to H1N1 flu:

Because the 2009 H1N1 flu can spread by droplets produced by an infected person who is coughing or sneezing, travelers are very susceptible to contracting this virus.

The CDC recommends that people, including children, intending to travel stay home if they are not feeling well. If your child feels ill upon returning from traveling, contact his or her health care provider.

To avoid potential exposure of your child to H1N1 flu, the CDC advises remaining informed about school closings and avoiding crowds and certain social situations.